Under the most ideal of circumstances, discussions about end-of-life care decisions are difficult, uncomfortable and often thought of as a talk better suited for a later time. For the past few years up through the present, several of my clients have asked me to explain the difference in different health care documents.
No one ever wants to think about the possibility of being incapacitated or in a terminal state. But if that were to happen, would your loved ones know what your wishes are? Would they know where you stand on being kept alive artificially?
Having your health care and end-of-life wishes documented and in place are important for not only your peace of mind but also for your loved ones who may be tasked with seeing your wishes are met.
But differentiating between the various advanced directive documents can be confusing!
Let’s look at two specific types of medical advanced directives – the DNR Order and the Living Will.
DNR
A Do Not Resuscitate Order (DNR) is just what it says: a medical order (written by a physician) that states your wishes not to receive cardiopulmonary resuscitation (CPR) if you have stopped breathing or if your heart has stopped. CPR includes cardiac compression, intubation, artificial ventilation, defibrillation, and other related procedures. A DNR order does not have instructions for other treatments, such as pain medicine, other medicines, or nutrition. You can only put a DNR in place with the assistance of your doctor.
LIVING WILL
Whereas the main job of the DNR is to state that you do not wish to receive CPR, the main job of the living will is to define whether you would or would not like to be kept alive artificially with medical interventions and life support measures (such as artificial nutrition and hydration, dialysis, painkillers, etc.) if in an end-of-life stage condition.
For a living will to go into effect, your doctor must certify that you either have a terminal illness or are in a persistent vegetative state and cannot make decisions for yourself. A living will is your voice while you are living but unable to express your medical care wishes.
These documents provide guidance to your loved ones about making medical decisions on your behalf. Without these documents, family and medical personnel are left to only guess what you really would have wanted.
Be Educated! Be Proactive!
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